Medicare Income-Related Appeals

What if the Social Security Administration says I have to pay a higher premium for Part B but I don't make the higher income anymore?  This is common especially when you retire.  Don't worry, you may be able to lower the premiums you have to pay for Part B.

Appealing Your Part B & D Premium   

As a beneficiary, you have the right to appeal if you believe that an Income Related Monthly Adjustment Amount (IRMAA) is incorrect for one of the qualifying reasons.  First, you must request a reconsideration of the initial determination from the Social Security Administration.  A request for reconsideration can be done orally by calling the SSA 1-800 number (800.772.1213) as well as by submitting the IRMAA appeal form (SSA-44). 

Below are the situations which may qualify a beneficiary for a new Part B determination: 

Situation

Description

Tax return inaccurate or out of date
  • A beneficiary filed an amended tax return for the year SSA is using to make an IRMAA decision
  • There was an error in the IRS data
  • The IRS provided SSA with older data and the beneficiary wants to use newer information
  • You had a major life-changing event that significantly reduced your income

Life-changing event that affects the beneficiary’s modified adjusted gross income

There are 7 qualifying life-changing events:

  • Death of spouse
  • Marriage
  • Divorce or annulment
  • Work reduction
  • Work stoppage
  • Loss of income from income producing property
  • Loss or reduction of certain kinds of pension income

Events that result in the loss of dividend income or affect a beneficiary's expenses, but do not affect the beneficiary's modified adjusted gross income are not considered qualifying life-changing events.

Click Here for Income-Related Appeal Form